| NPI | 1518130590 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CICELY EASON Executive Administrator 954-935-6063 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: FL ME43827) |
| Enumeration Date | 2008-04-10 |
| Last Update Date | 2008-04-10 |